How to fix this insane mess: Where de Blasio should look in his 30-day review of how the city handles serious mental illness

By Mark Peters and Lesley Brovner

New York Daily News|

Oct 21, 2019 | 5:00 AM

Not thriving. (Michael Appleton/Mayoral Photography Office)

In response to the murders of four people in Chinatown and the subsequent violent attack on a 6-year-old boy in Queens, both allegedly by mentally ill homeless men, Mayor de Blasio announced a 30-day review of how the city uses intensive mental health interventions to make sure potentially violent people struggling with serious psychological problems receive the treatment they need.

If the mayor is serious about meaningful reform here are some of the fundamental issues the review must consider.

Advertisement

The first problem is the most obvious: The number of homeless in the city is increasing every year, and according to the Coalition for the Homeless has almost doubled in the last decade. To be clear, not all of the homeless have mental health issues and not all people with mental health issues are violent. That said, people living on the street who do struggle psychologically are unlikely to get the ongoing and continuous services they need, which frequently puts them on a dangerous downward spiral.

As a result, there needs to be an increase in supportive housing which provides not only shelter but on-sight psychiatric services. Right now there are not nearly enough beds in supportive housing for the present eligible population, and that population is expected to increase. Finding a way to substantially increase supportive housing must be part of any long-term reform.

Advertisement

A related concern is that many of the city’s existing shelters are so dangerous that homeless people would often prefer to live on the streets. During our time running New York City’s Department of Investigation, we did two reports detailing these unsafe conditions, including firetraps, decaying rodents in bedrooms, rampant prostitution activity and a lack of essential services. Not only does the city need to create more shelters, but it needs to make them safe so that the homeless are comfortable coming in off the streets.

The next issue for consideration must be Thrive NYC, presently the city’s main initiative for providing mental health services. The time has come to recognize that Thrive, which has a $225 million-dollar annual budget, is failing. A scathing report from the city controller earlier this year found that the program lacked a “clear definition of the program’s purpose and criteria” and less than a third of all Thrive programs “had completed or planned evaluations” of their efficacy.

A well-functioning mental health services program is essential and if Thrive is to be that program, the 30-day review must consider a drastic revamping of the way Thrive is managed.

The NYPD is part of this 30-day review, which is good because there are criminal justice issues at play as well. When mentally ill people end up on Rikers, it is unclear whether the system is equipped to provide the help they need. Several years ago, while at DOI, we did a report finding that the jail’s then-private health-care provider completely failed to deliver needed services. The city replaced this private company with the public hospital system. The time has come for a new review as to whether H+H is doing any better.

All of these issues will become more urgent when the state’s new bail law goes into effect this January. Under the new statute, bail cannot be imposed for misdemeanors — even violent ones — with limited exceptions. Nor can it be imposed for certain low-level felonies. Finally, under the new law a judge can no longer consider ties to the community when setting bail, making it harder to confine a mentally ill homeless person in desperate need of intervention.

The tragedies that occurred in Chinatown and Queens this month were a long time in the making. The city needs and deserves a deep dive into how we got here and a plan for providing help before more people are injured. This 30-day review must not be squandered.

Peters and Brovner are the founding partners of the law firm Peters Brovner LLP. Previously, they served as commissioner and first deputy commissioner of DOI.